Page 1 of 2 12 LastLast
Results 1 to 15 of 18

Thread: The disc between cervical and thorasic

  1. #1
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227

    The disc between cervical and thorasic

    I HAVE A QUESTION.
    Is the disc between c-7 and t-1 considered cervical or thorasic?? I am in an argument with the insurance company about the matter. If it is cervical --they will not pay for the epidural the doctor ordered at that level. If it is thorasic--I may be able to get it payed for by them. What to do==I really thought it was both.
    Sometimes it makes you wonder who is in charge and WHY??? is it so hard to get an approval for care??Anyone know which it is?
    Help Please!

  2. #2
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,166
    Quote Originally Posted by jackieg412 View Post
    I HAVE A QUESTION.
    Is the disc between c-7 and t-1 considered cervical or thorasic?? I am in an argument with the insurance company about the matter. If it is cervical --they will not pay for the epidural the doctor ordered at that level. If it is thorasic--I may be able to get it payed for by them. What to do==I really thought it was both.
    Sometimes it makes you wonder who is in charge and WHY??? is it so hard to get an approval for care??Anyone know which it is?
    Help Please!
    That seems totally ridiculous. There's no answer to the question. I would ask the physiatrist to ask for a peer-to-peer review with the insurer.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    http://www.scoliosislinks.com/AboutMe.htm

  3. #3
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,166
    I just read the full issue on another thread. Having WC in the issue changes everything, though you may still need your doctor to work with your case worker.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    http://www.scoliosislinks.com/AboutMe.htm

  4. #4
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227
    Thanks Linda for your reply. It is a WC issue. I have my lawyer invoved in it also. I keep trying to move it forward. I have waited since Dec.5 no answer as of yet. I had to get the WC rejection before my medicare would pay. It is one phone call after another and no answer yet .Can anyone say if that disc is thorasic or cervical or is just both?

  5. #5
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    952
    Hi Jackie,

    I think anatomically it is cervical. Each disc is described in relation to the vertebrae it is under I believe. So I think the disc between C7-T1 is called C7's disc. Also, the injections are not into the disc but into the nerve roots, so in that case it would be the C7 nerve roots being injected.

    Best of luck with this. I can't imagine how aggravating this is for you.
    Gayle, age 46
    Boston brace as a teen for AIS
    Oct. 2010 fusion T8-sacrum w/ pelvic fixation, TLIF at L4/5.
    Feb 2012 major A/P revision for broken rods


    mom of Leah, 12 y/o, diagnosed Jan '08 with 26* thoracic JIS (age 6)
    4/08 26 degrees, brace 16 hrs/day
    9/08 17 deg. OOB - brace discontinued
    9/09 30 deg, resuming brace
    5/10 VBS Dr Luhmann Shriners St Louis
    11/13 stable 3.5 yrs post-op, 15 deg

    also mom of Torrey, 9 y/o son, 12* T, decreasing spontaneously (from 19*)

  6. #6
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,166
    I've never heard or seen discs numbered anything other than a combination of the vertebra above and the vertebra below.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    http://www.scoliosislinks.com/AboutMe.htm

  7. #7
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,017
    How do these WC people sleep at night after dealing with people in need of pain relief in such a callous an frankly idiotic manner? This is ONE spine. Just because one part gets injured doesn't mean that can't have ramifications to other parts. It should be beneath them to do this to another person.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  8. #8
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,059
    Quote Originally Posted by jackieg412 View Post
    I HAVE A QUESTION.
    Is the disc between c-7 and t-1 considered cervical or thorasic?? I am in an argument with the insurance company about the matter. If it is cervical --they will not pay for the epidural the doctor ordered at that level. If it is thorasic--I may be able to get it payed for by them. What to do==I really thought it was both.
    Sometimes it makes you wonder who is in charge and WHY??? is it so hard to get an approval for care??Anyone know which it is?
    Help Please!
    Jackie: it is my understanding that payment is contingent on: ICD9 diagnosis and procedure/treatment that fits the code. Most of the time, pre authorization is required. Do you know how your doctor billed for services? Susan...medical billing paperwork is always a bitch
    Dxed 8/2011: Degenerative Adult-Onset Scoliosis age 65
    XRAY 1/2012: 25* T levoscoliosis/ 36* L dexroscoliosis w/ 4.1 cm coronal & 3.5 cm sagittal balance
    XRAY: 12/2012: Scoliosis curve same, Coronal Balance increased to 11.2 cm. T kyphosis 90 degrees
    Severe disc degeneration thoracic & lumbar, stenosis esp L4
    Surgery: T3 to S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries,
    19 & 22 March 2013, Dr. Serena Hu @ UCSF
    Postop incisional hernia @ ALIF incision, repaired 3/2014

  9. #9
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227
    Hi to my Friends
    All of your help is good for me---it might not change anything but it is good support for me. about my WC case --it is settled with open medical until the insurance company can fund a medicare set aside dollar amount. They have had since last July to do so. no money yet for me--so the law says they pay. and they don't want to do that --so they fight. All along the insurace company has agreed to pain control and I think the epidural is for PAIN.But it is not approved. I do not know how the doctor visit was billed to them but I do have the codes for the epidural. As Follows:
    Thorasic back pain{315256}.neck pain{138037}
    comments:epidural injection x 2 for cervicothorasic pain.
    The pain doctor diagnosisis coded 723.9 and several other codes are there as well.
    We all know it is not unusual to have a problem with these long fusions and I only have this one disc as I am fused c5,6,7 and then t1-pelvis. This poor disc takes a lot!
    I am trying to have it done through my medicare,but I needed Wc to say no{and they did} and My spine doctor is not accepting my form of medicare as of 12/31/2013.
    It is a very big issue.

  10. #10
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,166
    Quote Originally Posted by Pooka1 View Post
    How do these WC people sleep at night after dealing with people in need of pain relief in such a callous an frankly idiotic manner? This is ONE spine. Just because one part gets injured doesn't mean that can't have ramifications to other parts. It should be beneath them to do this to another person.
    I have no love for WC employees, but they have to deal with a huge amount of fraud. So, I think they're essentially being forced to overreact to everyone. It's truly unfortunate that some horribly dishonest people are responsible for making millions suffer.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    http://www.scoliosislinks.com/AboutMe.htm

  11. #11
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227
    Yes Linda is right-- the workers comp employees can be difficult. I know that FRAUD is the main issue or at least their main issue when denying treatment. I have had 5 different adjustor's during my very long 6 years. Two of them were OK and the other 3 made every part of this long journey a trial.I know the idea is to wear the patient out. I still wonder way it is so very difficult.
    My hard part is the injury was complicated by the fact I had scoiliosis. And scoliosis complicates a lot of areas of the spine. And each area has an effect on the other one . Then the legal system gets involved and trys to make it all seam unnecessary treatment. It is expensive but you can't really call it unnecessary.
    I am waiting for what is called a MSA{medicare setaside agreement}Medicare is refusing to pay because workers comp is to pay ---and right now everyone is saying the other is responsible. And I have to wait it out. I have been doing this since last July---waiting that is. When the MSA is funded--I will have a trust fund of money to pay medical expences with{relating to injury and surgery}. At least then I will not have to deal with the adjustors for the insurance company.I just have to keep very good records.
    So I am still waiting .
    I hope to know this week about the epidural. That is if medicare approves it.

  12. #12
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227
    Epidural update--
    It is now Feb 13 and still no approval for epidural The dr ordered it on Dec 5.I am awaiting a call from my medicare{HMO} . it is to take place tomorrow--I have seen all people needed for a referral that is needed and the insurance company has not given approval. They are to call back in the next hour or it has to be cancelled for tomorrow. WHY is this so difficult????
    I needed to change primary doctors,I did that, I got the new doctor's OK last week, I got on the schedule to have injection and need the approval of the insurance--and it is being delayed. I was really counting on it--I had a driver in place-- made all arrangments--and found out today that it had not been approved. WHY? WHY? WHY? Since it has been like this all along for me--I just need to accept that everything will be difficult.Happy Valentine's day to all!!

  13. #13
    Join Date
    Jan 2014
    Posts
    27
    Quote Originally Posted by jackieg412 View Post
    Epidural update--
    It is now Feb 13 and still no approval for epidural The dr ordered it on Dec 5.I am awaiting a call from my medicare{HMO} . it is to take place tomorrow--I have seen all people needed for a referral that is needed and the insurance company has not given approval. They are to call back in the next hour or it has to be cancelled for tomorrow. WHY is this so difficult????
    I needed to change primary doctors,I did that, I got the new doctor's OK last week, I got on the schedule to have injection and need the approval of the insurance--and it is being delayed. I was really counting on it--I had a driver in place-- made all arrangments--and found out today that it had not been approved. WHY? WHY? WHY? Since it has been like this all along for me--I just need to accept that everything will be difficult.Happy Valentine's day to all!!
    Jackieg412,

    I hope this has since been worked out. I feel for you as I know how the bureaucracy of insurers can wear the most diligent person to the bone. The outrage is when you sick and no energy to give the fight.

    Hang in there.

    Scojo

  14. #14
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227
    I did have the epidural on Monday the 17th. It was a rough one for sure. They used a different name for it. Maybe because of the level at c7 _t 1.It actually really hurt down my left arm. I do mean hurt. I spoke to the Dr and will see him on Friday. We are supposed to do another one.I can't say this one helped. It did give me energy.

  15. #15
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    227
    I saw the dr on Friday--we are going to try another epidural for the upper thorasic pain--the first one didn't help too much but I will try another one. I know that we are just buying more time as I do not want to add to the fusion right now. Everything says that the disc is not holding up--but maybe we can keep me comfortable for awhile.
    Has anyone heard of a hardware block?? The hardware at the junction of my 2 surgeries is giving me problems and the doctor talked about doing a hardware block.Anyone had one??

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •